[Surgery or not on an atypical breast lesion? Taking anxiety into account in shared decision support from a prospective cohort of 300 patients].

Autor: Favier A; AP-HP (Assistance Publique des hôpitaux de Paris), department of gynecological and breast surgery and oncology, Pitié-Salpêtrière University Hospital, Paris, France. Electronic address: amelia_favier@hotmail.com., Boinon D; Psycho-oncology unit, Gustave-Roussy, université Paris-Saclay, Villejuif, France; Université de Paris, LPPS, 92100 Boulogne Billancourt, France., Salviat F; Service de biostatistique et d'épidémiologie, Gustave-Roussy, Villejuif, France; CESP Inserm U1018, université Paris-Saclay, université Paris-Saclay, Villejuif, France., Mazouni C; Gustave Roussy, Villejuif, France., De Korvin B; Radiology center, centre Eugène-Marquis, CLCC, Rennes, France., Tunon C; Institut Bergonié, Bordeaux, France., Salomon AV; Institut Curie, université Paris-Sciences Lettres, Inserm U934, département de médecine diagnostique et théranostique, Paris, France., Doutriaux-Dumoulin I; Institut cancérologique de l'Ouest, Saint-Herblain, France., Vaysse C; Département de chirurgie, CHU-Toulouse, institut universitaire du cancer de Toulouse-Oncopole, Toulouse, France., Marchal F; Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France., Boulanger L; Centre Oscar Lambret, Lille, France., Chabbert-Buffet N; Hôpital Tenon, Sorbonne university, Paris, France., Zilberman S; Hôpital Tenon, Sorbonne university, Paris, France., Coutant C; Centre Georges François Leclerc, Dijon, France., Espié M; University of Paris, Breast Unit, hôpital Saint-Louis, AP-HP, Paris, France., Cortet M; Service de gynécologie-obstétrique, hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France., Boussion V; Centre Jean-Perrin, Clermont-Ferrand, France., Cohen M; Institut Paoli Calmettes, Marseille, France., Fermeaux V; Service de pathologie, CHU Dupuytren, Limoges, France., Mathelin C; Les Hôpitaux universitaires de Strasbourg, Strasbourg, France., Michiels S; Service de biostatistique et d'épidémiologie, Gustave-Roussy, Villejuif, France; CESP Inserm U1018, université Paris-Saclay, université Paris-Saclay, Villejuif, France., Delaloge S; Gustave Roussy, Villejuif, France., Uzan C; AP-HP (Assistance Publique des hôpitaux de Paris), department of gynecological and breast surgery and oncology, Pitié-Salpêtrière University Hospital, Paris, France; Sorbonne University, Inserm UMR_S_938, 'Cancer Biology and Therapeutics', centre de recherche Saint-Antoine (CRSA), Paris, France; Institut universitaire de cancérologie (IUC), Paris, France., Charles C; Université de Bordeaux, Bordeaux Population Health (U1219), équipe méthodes pour la recherche interventionnelle en santé des populations (MéRISP), Bordeaux, France.
Jazyk: francouzština
Zdroj: Gynecologie, obstetrique, fertilite & senologie [Gynecol Obstet Fertil Senol] 2022 Feb; Vol. 50 (2), pp. 142-150. Date of Electronic Publication: 2021 Sep 22.
DOI: 10.1016/j.gofs.2021.09.010
Abstrakt: Introduction: Organized and individual breast screening have been accompanied by an increase in the detection of "atypical breast lesions (ABL)". Recently, the NOMAT multicenter study proposed a predictive model of the risk of developing breast cancer after detection of an ABL in order to avoid surgical removal of "low-risk" lesions. It also aimed to provide information on psychological experience, in particularly anxiety, to assist in the shared medical decision process.
Methods: Three hundred women undergoing surgery for ABL were included between 2015 and 2018 at 18 French centers. Women completed questionnaires before and after surgery assessing their level of anxiety (STAI-State, STAI-Trait), their level of tolerance to uncertainty, their perceived risk of developing a breast cancer, and their satisfaction with the management care.
Results: One hundred nighty nine patients completed the STAI-Status before and after surgery. Overall, a decrease in anxiety level (35.4 vs 42.7, P<0.001) was observed. Anxious temperament and greater intolerance to uncertainty were significantly associated swith decreased anxiety (33%), whereas younger age was associated with increased anxiety (8%).
Conclusion: Surgery for ABL seems to be associated with only a few cases with an increase in anxiety and seems to increase the perception of the risk of developing breast cancer. Taking into account the psychological dimension remains in all cases essential in the process of shared therapeutic decision.
(Copyright © 2021 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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